FTLO Health Declaration Form | FTLO Travel
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Health
Declaration
Form

 

As your trip approaches, we will ask you to complete a Health Declaration Form which will be sent to you via email 48 hours before your trip. A SAMPLE form is provided below.

 

Health Declaration Form last updated 1/26/24.

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Health

Declaration Form

(SAMPLE)

1. I attest that I do not have symptoms of Covid or Influenza: *

I confirm that I am currently not experiencing any symptoms commonly associated with COVID-19 or Influenza, such as fever, cough, difficulty breathing, loss of taste or smell, or any other symptoms outlined by health authorities. I have not tested positive for COVID-19 within the past 14 days.

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2. I acknowledge the risk of contracting illness during travel: *

I understand that traveling involves potential exposure to various illnesses, including Covid and Influenza, and there is a heightened risk of contracting such illnesses during travel.

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I acknowledge the risks associated with group travel and, if I have booked a shared room, with shared accommodations:

​I understand that choosing to share accommodations with other travelers may involve inherent risks, including the potential for increased exposure to illnesses. I will take necessary precautions and follow any guidelines provided to minimize these risks.

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3. I acknowledge the risk of exposure to illness associated with group travel:

I understand that choosing to share transportation and accommodations with other travelers may involve inherent risks, including the potential for increased exposure to illnesses. I will take necessary precautions and follow any guidelines provided to minimize these risks.

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4. I understand the importance of practicing good hygiene: *

I acknowledge the significance of practicing regular hand hygiene, including turning away when I sneeze, and washing hands with soap and water for at least 20 seconds or using hand sanitizer when soap and water are not available. I will make every effort to maintain good hygiene practices throughout the trip.

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5. I agree to comply with local health and safety regulations: *

I understand that local health and safety regulations may vary at each destination we visit. I will familiarize myself with and comply with any specific guidelines or protocols provided by the trip organizers and local authorities to ensure the safety of myself and others.

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6. I will inform the trip leader of any changes in my health status: *

I commit to promptly informing the Trip Leader if there are any changes in my health status during the trip, including the development of Covid or Influenza symptoms. This will enable appropriate measures to be taken to safeguard the health of the group.

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7. By submitting this Health Declaration Form, I acknowledge that providing accurate information is crucial for the well-being of all travelers, our staff, and the communities we visit: *

I understand that failure to adhere to these guidelines may jeopardize the health and safety of others during the trip.

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